Regular exercise training has been shown to reduce mortality, improve functional capacity; and control the risk factors in myocardial infarction (MI) patients. Heart rate recovery (HRR) is a strong independent mortality predictor in patients with previous MI.The main objective of this study was to investigate the impact of exercise training on heart rate recovery in patients post anterior myocardial infarction.We recruited patients one month after having anterior MI who were referred to cardiac rehabilitation (CR) clinic in Ain Shams University hospital between October 2016 and July 2017. All the patients participated in exercise training sessions 3 times a week for 12 weeks. Symptom limited treadmill exercise test was done before and after exercise training program to calculate heart rate recovery in 1st minute (HRR1) and 2nd minute (HRR2).A total of 50 patients, including 44 (88%) males, completed the exercise training program. The mean age was 51 years. Statistically significant improvement in HRR1 and HRR2 was observed (p value <0.001) after completion of exercise based cardiac rehabilitation program. Significant improvement in resting heart rate was also observed (p value <0.001). Moreover, metabolic equivalent (METs) and HR reserve were improved significantly (p value <0.001). No statistically significant changes were observed in resting systolic and diastolic blood pressures and maximum HR (p value = 0.95, 0.76 and 0.31 respectively).Exercise training improves HRR, resting HR, METs and HR reserve in post anterior MI patients.
The date palm (Phoenix dactylifera L.) is one of the oldest cultivated trees and is an important allpurpose tree.About 105 million date palms are planted in Africa and Central America, Spain and Italy, but in Egypt have 16 million.The date palm is one of the important crops that is considered a strategic crop, and the date palm suffers from diseases, the symptomatic tree streaking's and yellowing to phytoplasma infection.The most important of which is phytoplasma disease, which is difficult to identify, this study using Molecular genetics has recently entered detection and genetic fingerprint of lethal yellowing disease, Polymerase chain reaction (PCR) assays using primer pairs designed for identification of phytoplasma using universal (R16mF2/R16mR1) primer 16Sr DNA sequences and specific nested (R16F2n/R16R2) a sensitive means of detecting this phytoplasma pathogen and a wide array of.The universal primer pair specifically for initiated amplification of among phytoplasma strains resulted in a DNA size of approximately 1500 bp in using gel electrophoresis.Nested PCR assays using the specific primer of phytoplasma in infected tissues resulted on a DNA of approximately 1200 bp. and Detection of LY-phytoplasma by the pathogen-specific primer pair LY1 (5ˋ-CAT ATT TTA TTT CCT TTG CAA TCTG-3ˋ), LY2 (5ˋ-TCG TTT TGA TGA TCT TTC ATT TGAC-3ˋ) designed for genomic DNA isolated from lethal yellow of windmill palm and electronics microscopy by transmission electron microscope At 70 kV, and Applied SEM Technology at sections of the infected leaves.This is examination of a phytoplasma associated with streak yellows on date palm in Egypt.
Abstract Background Vitamin D deficiency is a prevalent condition that is found in about 30–50% of the general population, and it is increasing as a new risk factor for coronary artery disease. Our study aimed to evaluate the relationship of serum vitamin D levels with coronary thrombus burden, Thrombolysis In Myocardial Infarction flow grade, and myocardial blush grade in patients managed by primary percutaneous coronary intervention for their first acute ST-segment elevation myocardial infarction. Results Eighty patients were included in the study with their first acute ST-segment elevation myocardial infarction and were managed by primary percutaneous coronary intervention. According to the serum concentrations of vitamin D, the study population was divided into 2 groups: group A with abnormal vitamin D levels less than 30 ng/ml (50 patients) and group B with normal vitamin D levels equal to or more than 30 ng/ml (30 patients). Angiographic data was recorded before and after coronary intervention. On comparing thrombus grade and initial and post-procedural Thrombolysis In Myocardial Infarction flow between both groups of patients, there was no significant difference ( p = 0.327, p = 0.692, p = 0.397). However, myocardial blush grade was better in patients with normal vitamin D levels ( p = 0.029) without a significant correlation between vitamin D concentration values and myocardial blush grade ( r = 0.164, p = 0.146). Conclusions Patients with first acute ST-segment elevation myocardial infarction and normal vitamin D levels undergoing primary percutaneous coronary intervention had better myocardial blush grade and more successful microvascular reperfusion in comparison with patients with abnormal vitamin D levels. There was no significant difference between the normal and abnormal vitamin D groups regarding the coronary thrombus grade and Thrombolysis In Myocardial Infarction flow.
Abstract Background The association between increased arterial stiffness and Left ventricular (LV) diastolic dysfunction (DD) has been well characterized, suggesting a close interaction between the arterial system and the left ventricle. Aortic pulse-wave velocity (PWV) is a measure of aortic stiffness, and it has an established prognostic role in cardiovascular diseases and in the general population. Aim Evaluation of aortic PWV assessed by echocardiography as a new diagnostic parameter for LV DD by correlation with current echocardiographic LV DD indices, and also evaluation of aortic PWV prognostic value in patients with DD by correlation with Brain natriuretic peptide (BNP). Methods This study was conducted at Ain-Shams and Helwan University hospitals from December 2017 to December 2018. It included 100 subjects aged from 55 to 60 years; they were divided into two groups, 1st group (case group): 80 patients with asymptomatic LV DD with preserved ejection fraction ≥50%, 2nd group (control group): 20 patients with normal diastolic function. All patients were subjected to full history and thorough physical examination. BNP, ECG and full echocardiography with assessment of aortic PWV were done. Results A total of 100 patients were enrolled, 38 (47.5%) males in case group vs. 9 (45%) in control group. Hypertension, diabetes and dyslipidemia were significantly higher in case vs. control (P-values: <0.001, 0.005, 0.002 respectively). Aortic PWV has significant positive correlation with both age and body mass index (r = 0.422, r = 0.847 respectively with P < 0.001 for both). Aortic PWV has significant positive correlation with E/e’ (r = 0.957, P < 0.001), tricuspid regurge velocity (r = 0.941, P < 0.001), and left atrial volume index (r = 0.947, P < 0.001), but it has significant negative correlation with septal e’ (r=-0.970, P < 0.001) and lateral e’ (r=-0.932, P < 0.001). Aortic PWV has significant positive correlation with plasma BNP level (r = 0.958, P < 0.001). Aortic PWV was significantly higher in case vs. control group with mean values (15.5±1.32 vs. 10.11±0.78 m/s respectively; P < 0.001). The area under the ROC curve for aortic PWV to detect DD was 0.86 (95% CI, 0.76–0.98; P < 0.001) and the optimal cutoff point of 12.5 m/s produced 92.3% sensitivity and 75.0% specificity (the positive and negative predictive values were 93.5 and 72.7%, respectively with an accuracy of 89.0%). Conclusion Echocardiographic assessment of aortic PWV appears not only to be a highly sensitive, reliable, easy, rapid and practical parameter for LV DD detection but also has a promising prognostic value in patients with LV DD.
There was statistically significant difference between all groups of giardiasis patients regarding the grade of CD4 lymphocyte infiltration (P<0.001), being more marked in symptomatic group. The prevalence of flatulence, anorexia and vomiting were more frequent in patients with heavy CD4 lymphocyte infiltration in duodenum. A high statistical significant increase was in the mean OD values of anti-Giardia duodenal secretory IgA in patients with marked CD4 infiltration in duodenum. But, a statistical insignificant difference in mean OD values of anti-Giardia total serum Ig in patients with different grades of CD4 infiltration in symptomatic group. There was statistically significant increased in the mean OD values of anti-Giardia total serum Ig in patients with marked intraepithelial CD8 lymphocyte Infiltration in the duodenum In the asymptomatic group, there was statistically insignificant difference in the mean OD values of anti-Giardia total serum Ig in patients with different grade of intra-epithelial CD8 infiltration in symptomatic group. There is statistically significant increased in the mean OD values of anti-Giardia total serum Ig in patients with marked intra-epithelial CD8 lymphocyte infiltration in the duodenum regarding immunohistochemical staining of Giardia antigen in duodenal biopsies. All the 61 symptomatic giardiasis patients revealed Giardia antigen stains in their duodenal biopsies with a sensitivity of 100% while asymptomatic group a sensitivity of 93.181%. None in the controls showed positive Giardia antigen in the duodenal biopsies with 100% specificity.
Improvement of functional capacity and mortality reduction in post-MI patients were found to be associated with regular exercise training. The cardiac magnetic resonance (CMR) is considered the most accurate non-invasive modality in quantitative assessment of left ventricular (LV) volumes and systolic functions. Our main objective was to investigate the impact of exercise training on LV systolic functions in patients post anterior MI using CMR. 32 patients on recommended medical treatment 4 week after having a successful primary PCI for an anterior MI were recruited, between May 2018 and May 2019. They were divided into two groups, training group (TG): 16 assigned to a 12 week exercise training program and control group (CG): 16 who received medical treatment without participating in the exercise training program. Treadmill exercise using modified Bruce protocol was done to TG before and after the training program in order to record the resting and maximum HR, metabolic equivalent (MET), and calculate HR reserve. CMR was performed for all patients 4 weeks after PCI and was repeated after completion of the study period to calculate ejection fraction (EF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), and wall motion score index (WMSI).100% were males. 6 patients from CG dropped during follow-up, no statistically significant difference between the two groups regarding age, BMI, smoking status, hypertension, diabetes mellitus and dyslipidemia. Using the CMR, the TG showed significant improvement in EF (36.6 ± 14.2% to 43.1 ± 12.4%; P < 0.001) and WMSI (2.03 ± 0.57 to 1.7 ± 0.49; P < 0.001), without statistically significant change in LV volumes. Regarding CG no significant changes in EF, WMSI, LV volumes were found. There was significant improvement in EF and WMSI change before and after study in TG vs. CG [6.5 (2.3-9.0) vs. - 2.0 (- 6.8 to 1.3), P value < 0.001] and [- 0.3 (- 0.5 to 0.1) vs. 0.1 (- 0.1 to - 0.5), P value 0.001] respectively.12 weeks of exercise training program in post-MI patients have a favorable impact on LV global and regional systolic functions without adversely affecting LV remodeling (as assessed by CMR).
In 19 children with hepatic fibrosis as the result of continued schistosomiasis mansoni and 20 children without hepatic fibrosis, the following studies were carried out: HLA antigen typing for 30 antigens, immune response of T lymphocytes to schistosome antigen by measuring DNA synthesis evidenced by 3H-thymidine uptake, and measurement of total OKT3+, OKT4+, and OKT8+ cells using monoclonal antibodies. Patients with hepatic fibrosis were mostly high responders in contrast with those without fibrosis. High immune response and susceptibility to post-schistosomal hepatic fibrosis were associated with a high frequency of A2 and B12 antigens and a lack of DR2 antigens, while low response was associated with the presence of the DR2 antigen. The T4+:T8+ ratio showed increased suppressor proportions in patients with low immune response and/or with no hepatic fibrosis. We suggest an immunogenetic susceptibility for post-schistosomal hepatic fibrosis, probably controlled by HLA-linked genes via the suppressor T cells.
Abstract Aims Our aim is to describe the clinical characteristics and management of patients hospitalized with acute heart failure (HHF) and ambulatory patients with chronic heart failure (CHF) in Egypt and compare them with heart failure (HF) patients from other countries in the European Society of Cardiology‐Heart Failure (ESC‐HF) registry. Methods and results The ESC‐HF Long‐term Registry is a prospective, multi‐centre, observational study of patients presenting to cardiology centres in member countries of the ESC. From April 2011 to February 2014, a total of 2145 patients with HF were recruited from 20 centres all over Egypt. Of these patients, 1475 (68.8%) were hospitalized with HHF, while 670 (31.2%) had CHF. Less than one‐third (32.1%) of all patients were females. HHF patients {median age of 61 years [interquartile range (IQR), 53–69]} were older than CHF patients [median age of 57 years (IQR,46‐64)]; P < 0.0001. They had more diabetes mellitus (45.4% vs. 31.8%; P < 0.0001). Left ventricular ejection fraction > 45% was present in 22% of HHF vs. 25.6% of CHF ( P = 0.17). Atrial fibrillation existed in about a quarter of all patients (24.5%). Ischaemic heart disease was the main cause of HF in Egyptian patients. All‐cause in‐hospital mortality was 5%. Egyptian patients presented at a much earlier age than in other regions in the registry. They had more diabetes mellitus. Atrial fibrillation prevalence was remarkably lower. Other co‐morbidities (renal dysfunction, stroke, and peripheral arterial disease) occurred less frequently. Conclusion Patients in the Egyptian cohort exhibited distinct features from HF patients in other countries in the ESC‐HF Long‐term Registry.
A total of 280 patients, 240 infertile and 40 pregnant were subjected to thorough history taking, general and local examination for exclusion of organic lesion, laboratory investigations to exclude parasitic, bacterial and fungal infections. Sterile vaginal swab from the posterior fornix was taken, and examined by wet smear preparation, Giemsa staining and cultivation on C.P.L.M. medium for trichomoniasis infection. The mean age of the infertile group was 25.75+/-3.92, and of the control group was 21.6+/-2.38 (in years). The mean duration of infertility was 2.81+/-1.51 (years). Out of 240 infertile women, 18.75% complained of discharge, 17.5% itching, 15.42% dysuria, 14.58% dyspareunia, and 10% had cervical lesion. Of the 40 controls, 5% complained of discharge, 2.5% complained of itching, dysuria, dyspareunia, but none had cervical lesion. Of the total cases (280), 36 (12.9%) had T. vaginalis. The clinical data observed were significantly higher among the infertile group than the control group. Cultures were positive in 14.58% of the infertile group and 2.5% in the control group. The difference between the 2 groups was statistically significant. No doubt, T. vaginalis plays an important role in female infertility.
Children less than 1 year of age are commonly colonized with toxin-producing C. difficile, but appear to be immune to the associated colitis. Animal studies suggest that young infants lack receptors for C. difficile toxin, though this has never been documented in humans. Tissue from infants (<6 months) and adults > 21 years were studied. Toxin A binding was assessed using an indirect staining method, which included incubation with toxin A (List Labs) and detection with a rabbit polyclonal anti-sera (Lee Labs). A trained pediatric pathologist assessed the extent of staining in a blinded fashion. In other studies, toxin A was labeled with rhenium-188 and incubated with albumin-blocked tissue sections (four-infant and six-adult) for 1 hour. After washing, gamma counts were measured and the average percentage of retained radiolabeled toxin A calculated. Fisher exact tests and ANOVA were used for analyses. All studies were done in compliance with our institutional IRB. Six of 13 (46%) adult specimens were found to have reactivity on both the apical epithelial surface as well as crypt staining. Another six had reactivity localized only to the basal and lateral surface of the crypts. One specimen demonstrated no reactivity at all. For neonates (n = 15), no specimens were found to have reactivity localized to the apical epithelial surface, though four specimens had reactivity at the basal epithelial surface (P value for comparison of apical staining 0.0046) (see figure). Average percentage of retained counts for control (no tissue), infant and adult colon sections were, 0.318 ± 0.147, 0.305 ± 0.079 and 0.48 ± 0.114, respectively (P = 0.051). Immunohistochemistry and radiolabelling studies indicate that neonatal colon section binds C. difficile toxin A less strongly and in a different distribution pattern (i.e., without apical staining) when compared with adult colon sections. These findings are consistent with previous animal studies and support the paradigm that a lack of toxin receptors in the infant colon contributes to immunity against C. difficile colitis. Additional studies are needed to define the presence of specific receptors and determine if a similar phenomenon applies to toxin B binding. All authors: No reported disclosures.
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